Emerging Presence of Culturable Microorganisms in Clinical Samples of the Genitourinary System: Systematic Review and Experience in Specialized Care of a Regional Hospital

The detection of emerging pathogens responsible for genitourinary infections has increased with technological advances. We conducted a systematic review of publications on the involvement of these microorganisms in genitourinary samples, and we also investigated their presence and antibiotic susceptibility in samples from patients at our regional hospital (Granada, Spain). The MEDLINE database was searched up to 31 December 2020, and a cross-sectional descriptive study was performed of results obtained in urine samples and genital exudates from January 2016 through December 2019. The review highlighted the frequent involvement of Neisseria meningitidis in genital infections, while the data on other microorganisms were consistent with findings in our patient series. The emerging microorganisms most often responsible for urinary tract infections were Streptococcus bovis (58.5%) and Gardnerella vaginalis (23.6%) in females, and S. bovis (32.3%), Aerococcus urinae (18.6%), and Corynebacterium spp. (16.9%) in males; those most frequently reported in genital infections were S. viridans (36.4%) in females and C. glucuronolyticum (32.2%) and G. vaginalis (35.6%) in males. In general, emerging pathogens are resistant to conventional antibiotics such as penicillin. However, there has also been an increase in beta-lactam resistance by the S. bovis group and Corynebacterium spp. The systematic review showed that emerging microorganisms are responsible for only a small percentage of genitourinary infections but are of major clinical interest, with a predominance of the S. bovis group, G. vaginalis, Lactobacillus spp., Aerococcus spp., and Corynebacterium spp. in urine samples and of G. vaginalis and C. glucuronolyticum in genital samples. Given the increasing resistance to antibiotics empirically prescribed in patients with genitourinary infections, it is recommended to create an antibiogram in all cases

¡No sé si reír o llorar! Secuencia de actividades verbo-tonales para la pronunciación del español

En este artículo se pretenden desarrollar una serie de actividades verbo-tonales dirigidas a estudiantes sinohablantes, que poseen determinadas desventajas lingüísticas respecto al español. Por una parte, se plantea favorecer la expresión y reconocimiento de las emociones, mientras que por otra parte se pretende fomentar la práctica del sonido [r]. La propuesta didáctica se compone de tres fases donde primero se presentan y practican las entonaciones del español, después se tratan las emociones asociadas con colores en base a la película Del revés (favoreciendo primero la destreza de comprensión auditiva y, después, la expresión oral). En la última fase los estudiantes ponen en práctica lo visto anteriormente a través de un juego lúdico. Así, con esta sesión didáctica, se pretende favorecer la competencia léxica, gramatical y pragmática-kinésicaque afecta a este colectivo en parte debido a motivos socioculturales

An example of adaptation: experience of virtual clinical skills circuits of internal medicine students at the Faculty of Medicine, University of Granada (Spain) during the COVID-19 pandemic

Background: The state of alarm declared in Spain in response to the Coronavirus pandemic (COVID-19) has had far-reaching consequences in all areas of life. At the University of Granada’s (UGR) Faculty of Medicine, online teaching was implemented immediately without any preexisting plan. Second-year undergraduates in medicine, particularly those enrolled in the subject ‘Bases of Internal Medicine,’ would normally undergo clinical skills circuits in faceto- face group settings. Objective: To facilitate undergraduates’ acquisition of specific transversal skills by means of an integrated online working system. Design: Before the pandemic, teaching/learning methods consisted of 1) face-to-face group work; 2) teletutoring; 3) written work uploaded to the PRADO online platform for marking by the teletutor; and 4) presentation of written work to the group. As a result of the lockdown, presentations in class were suspended and replaced by online presentations. The means adopted by students in online presentations were freely chosen using various communication techniques: linear projection systems (6); acting/simulation (4); dramatization (1); and roleplaying (1). Results: The number of online clinical skills circuits developed was 12, one for each of the clinical skills circuits established for imparting this subject. A total of 12 presentations were made by the 10 groups, each lasting 15 minutes followed by a 5-minute discussion to settle any questions raised. The presentations were marked jointly by the teaching staff, coordinator, and students. Conclusions: The transference of classroom learning to the online environment proved an essential resource for teaching/learning clinical/practical skills during the lockdown, which have never before been imparted at distance

Relationship between genotoxicity and oxidative stress induced by mercury on common carp (Cyprinus carpio) tissues

Artículo científicoMercury is one of the most toxic metals in aquatic systems since it is able to induce neurobehavioral disorders as well as renal and gastrointestinal tract damage. The common carp Cyprinus carpio is an important species from both an ecological and economic viewpoint as it is consumed in many countries, the top producers being Mexico, China, India and Japan. The present study aimed to evaluate the relation between Hg-induced oxidative stress and genotoxicity in diverse tissues of C. carpio. Specimens were exposed to 0.01 mg Hg/L (the maximum per- missible limit for aquatic life protection), and lipid peroxidation, protein carbonyl content and the activity of antioxidant enzymes were evaluated at 96 h. Micronuclei frequency and DNA damage by comet assay were determined at 12, 24, 48, 72 and 96 h. Hg induced oxidative stress and genotoxicity on exposed fish, since inhibition of antioxidant enzymes activity and increases in lipid peroxidation, DNA damage and micronuclei frequency occurred. Blood, gill and liver were more susceptible to oxidative stress, while blood were more sensitive to genotoxicity. In conclusion, Hg at concentrations equal to the maximum permissible limit for aquatic life protection induced oxidative stress and genotoxicity on C. carpio, and these two effects prove to be corre- lated.Consejo Nacional de Ciencia y Tecnología (CONACyT, Project 181541) as well as the Secretaría de Investigación y Posgrado of the Instituto Politécnico Nacional, Mexico (SIP-IPN, Projects 20160871 and 20170931)

El rol del psicólogo en relación a voluntades anticipadas y derecho a morir dignamente (Estado del arte)

2 p.For a few years they have generated a series of judgments and values about the use and scope of advance directives against the right to die with dignity, medical staff and the interdisciplinary team involved in terminal chronic patients continues to be debated to respect their ethical and moral versus topic or follow a series of new ethical rules intended to do any harm to this and respect the final will of the patient so from there the concept of the role of psychologists related against the decision of a dignified death, taking into account regulatory changes and case law in Colombia. Objective: To determine the role of the psychologist regarding Advance Directives and the right to die with dignity. Method: The research includes documentary review of the concept and scope of the role of psychologists against living wills and the right to die with dignity. Data collection and use of information sources was made by the hermeneutical method for the analysis and interpretation of texts. Conclusions: The dialectic of life confronts us with the reality of their own and others death and the eventual decision in that context, it is important the attitude that takes a person or family facing a situation chronic health terminal; while there is some dichotomy and confrontation with what is desired and what is permitted or endorsed by the regulations. It should be noted that life and death change their meaning from one culture to another and are influenced by the beliefs of what is lived and felt in every moment of existence. The role of the psychologist is part of two key processes neutrality in the accompanying decision to reactions of the disease condition, and the grieving process that would guide and approach the subjectivism of advance or the right to die with dignity. Understanding the roles of psychologists fall into biopsychosocial interventions, decision making reactions to the disease, and intervention in the grieving process, providing comprehensive care of each subject and its key sickness.Durante algunos años se ha generado una serie de juicios y valores acerca del uso y el alcance de la voluntad anticipada frente al derecho de morir dignamente. El personal médico y el equipo interdisciplinar que intervienen al paciente crónico terminal continúan en el debate acerca de si respetar su ética y su moral frente al tema, o seguir una serie de nuevas normas éticas que pretenden hacer el menor daño al paciente y respetar su voluntad final. Desde allí se relacionó el concepto del Rol del Psicólogo frente a la toma de decisiones sobre una muerte digna, teniendo en cuenta los cambios normativos y la jurisprudencia en Colombia. Objetivo: Determinar el rol del psicólogo en relación a Voluntades anticipadas y derecho a morir dignamente. Método: La investigación incluye la revisión documental del concepto y alcance del rol del psicólogo frente a las voluntades anticipadas y el derecho a morir dignamente. Para la recolección de dato, el uso de las fuentes de información, y el análisis e interpretación de los textos se hicieron por medio del método hermenéutico. Conclusiones: La dialéctica de la vida nos enfrenta con la realidad de la muerte propia y ajena, así como a la eventual toma de decisiones en dicho contexto, en el que es importante la actitud que adopta una persona o su familia frente a una situación de salud crónica terminal; en tanto existe cierta confrontación y dicotomía con lo que se desea y lo que está permitido o avalado por la normatividad. Debe tenerse en cuenta que la vida y muerte varían su significado de una cultura a otra y se ven influenciadas por las creencias de lo que se vive y siente en cada momento de la existencia. El rol del psicólogo se enmarca en dos procesos claves la neutralidad en el acompañamiento en la toma de decisiones ante reacciones de la condición de enfermedad, y el proceso de duelo que permitiría guiar y aproximarse al subjetivismo de las voluntades anticipadas o el derecho a morir dignamente. Entendiendo que los roles del psicólogo se encuadran en intervenciones biopsicosociales, en la toma de decisiones ante reacciones de la enfermedad, y la intervención en los procesos de duelo, brindando así una atención integral de cada sujeto y su enfermedadPregradoPsicólog

Evidence of ongoing radial migration in NGC 6754: Azimuthal variations of the gas properties

Understanding the nature of spiral structure in disk galaxies is one of the main, and still unsolved questions in galactic astronomy. However, theoretical works are proposing new testable predictions whose detection is becoming feasible with recent development in instrumentation. In particular, streaming motions along spiral arms are expected to induce azimuthal variations in the chemical composition of a galaxy at a given galactic radius. In this letter we analyse the gas content in NGC 6754 with VLT/MUSE data to characterise its 2D chemical composition and H$\alpha$ line-of-sight velocity distribution. We find that the trailing (leading) edge of the NGC 6754 spiral arms show signatures of tangentially-slower, radially-outward (tangentially-faster, radially-inward) streaming motions of metal-rich (poor) gas over a large range of radii. These results show direct evidence of gas radial migration for the first time. We compare our results with the gas behaviour in a $N$-body disk simulation showing spiral morphological features rotating with a similar speed as the gas at every radius, in good agreement with the observed trend. This indicates that the spiral arm features in NGC 6754 may be transient and rotate similarly as the gas does at a large range of radii.Comment: 8 pages, 4 figures, accepted for publication in ApJL 2016 September 2

Use of Aerial Laser Scanning to Assess the Effect on C Sequestration of Oak (Quercus ilex L. subsp. ballota [Desf.]Samp-Q. suber L.) Afforestation on Agricultural Land

Conversion of agricultural lands to forest plantations to mitigate rising atmospheric carbon dioxide (CO2) has been proposed, but it depends on accurate estimation of the on-site carbon (C) stocks distribution. The use of aerial laser scanning (ALS) data is a rapidly evolving technology for the quantification of C stocks. We evaluated the use of allometric models together with high-density ALS data for the quantification of biomass and soil C stocks in a 14-year-old Quercus ilex and Q. suber plantation in Southwestern Spain. In 2010, a field survey was performed and tree dasometric and biomass variables were measured. Forty-five soil profiles (N = 180 soil samples) were taken systematically and the soil organic C content (SOC) was determined. Biomass and soil organic C values were regressed against individual dasometric variables and total tree height was used as a predictor variable. Aerial laser scanning data were acquired with a point density of 12 points m−2. Relationships among ALS metrics and tree height were determined using stepwise regression models and used in the allometric models to estimate biomass and SOC C stocks. Finally, a C stock map of the holm-cork oak cover in the study area was generated. We found a tree total biomass of 27.9 kg tree−1 for holm oak and 41.1 kg tree−1 for cork oak. In the holm oak plantation, the SOC content was 36.90 Mg ha−1 for the layer 0–40 cm (SOC40) under the tree crown and 29.26 Mg ha−1 for the inter-planted area, with significant differences from the reference agricultural land (33.35 Mg ha−1). Linear regression models were developed to predict the biomass and SOC at the tree scale, based on tree height (R2 >0.72 for biomass, and R2 >0.62 for SOC). The overall on-site C stock in the holm-cork oak plantation was 35.11 Mg ha−1, representing a net C stock rise of 0.47 Mg ha−1 yr−1. The ALS data allows a reliable estimation of C stocks in holm and cork oak plantations and high-resolution maps of on-site C stocks are useful for silvicultural planning. The cost of ALS data acquisition has decreased and this method can be generalised to plantations of other Mediterranean species established on agricultural lands at regional scales. However, an increase of filed data and the availability of local biomass and, in particular, SOC will improve accurate quantification of the C stocks from allometric equations, and extrapolation to large planted areas

Retos del manejo de la anticoagulación en pacientes portadores de prótesis mecánicas cardiacas con accidentes cerebrovasculares hemorrágicos

The management of anticoagulation in patients who have suffered a hemorrhagic stroke represents a difficult clinical scenario, in which individualized evaluation of both the hemorrhagic and thrombotic risk is essential. We present a case of a patient, who have a mechanical heart valve and an ischemic stroke with hemorrhagic transformation, and the complications she had due to her clinical situation.El manejo de la anticoagulación en pacientes con accidentes cerebrovasculares hemorrágicos supone un escenario clínico complejo en el que es fundamental evaluar el tanto el riesgo hemorrágico como el trombótico de manera individualizada. Se presenta el caso de una paciente con una prótesis mecánica cardiaca y un accidente cerebrovascular con transformación hemorrágica, y las complicaciones derivadas de su situación clínica

Hematoma de septo interauricular como complicación postquirúrgica inusual: A propósito de un caso

Atrial septal hematoma is a rare entity that can be caused by various etiologies. Mitral valve surgery is the most common iatrogenic cause of atrial septal hematoma or dissection, although it has also been described as a complication of other surgical and percutaneous procedures. We present a case of a woman with an interatrial septal hematoma as a post-surgical complication. Through this clinical case we will briefly review this rare entity.El hematoma del septo interauricular constituye una entidad poco habitual que puede tener diferentes etiologías. La cirugía sobre la válvula mitral es la causa iatrogénica de hematoma o disección de septo interauricular más frecuente, aunque también se ha descrito como complicación de otros procedimientos tanto quirúrgicos como percutáneos. Presentamos un caso de una mujer con un hematoma de septo interauricular como complicación postquirúrgica. A través de este caso clínico haremos una pequeña revisión de esta rara entidad